Murky-Lengthiness | 2 points
Therapeutic Efficacy of Ivermectin as an Adjuvant in the Treatment of Patients with COVID-19 Study conducted at the Social Security Institute for Workers of the State of Chiapas, ISSTECH, Mexico[-] TrumpLyftAlles | 2 points
I'm afraid that this study reveals nothing about the efficacy of ivermectin against covid-19, for the simple reason that ALL the patients got the drug. To discern an impact, trials compare those who receive a treatment to those who do not. This study doesn't report anything about untreated patients, so it's impossible to tell what effect ivermectin had.
Of the total number of patients treated, 38% (41) died, of which two (2%) outpatients, 18 (17%) severe inpatients and 21 (19%) patients cared for in critical condition.
That would be meaningful if a well-known, established model had been applied that used a given patient's attributes to compute the probability of that patient dying. Then the researchers would be able to make the statement "The predicted number of deaths among outpatients was 7 and only 2 died, implying that ivermectin prevented 5 deaths." No such model exists (AFAIK) and of course wasn't applied here.
The same problem comes up with the Argentine "study" (reported in a 2:18 min:second video) where 135 confirmed covid-19 positive patients with mild disease were given ivermectin, and NONE advanced to a more severe stage of disease. The presenter states that it would be expected for 5% of the 135 to get sicker, which would be 7 patients. Therefore ivermectin may be credited with preventing 7 patients from getting sicker. The study conclusion is based on that 5% number. I haven't looked really hard and my google skills may suck, but I haven't been able to find corroboration of the 5% figure. It sounds reasonable, the 5% -- but that doesn't matter. Such claims need backing research, to be credible.
In this study, 24 patients were treated as outpatients ("external consultation"). Applying the Argentine researcher's 5%, we would expect (24 * .05 =) 1.2 of those patients to advance to a worse stage. In fact, 2 died. Thus, we may infer that treatment with ivermectin (etc) made patients worse.
Is that a valid conclusion? No. The 5% is an impossible number to know, because it depends so much on the attributes of those in the population, days since the onset of the disease, etc.
The only way to know is with a control arm.
I fear this is going to be a continuing problem with ivermectin: no one conducting a study can accept giving their patients NO treatment or a known-to-be-inferior treatment.
In this study, outpatients received "Ivermectin 12 mg V.O; Repeat doses: 12 mg v.o at 48 hours; Paracetamol 500 mg v. for 5 days; Ketorolaco 10 mg v.o c-8 hs in case of pain and Atorvastatin 40 mg c-24 hours a month" Couldn't the researchers have refrained from giving ivermectin to a random subset of the outpatients? Apparently not.
The two Bangladesh trials have positive but hard-to-understand results because they compare ivermectin + doxycycline to hydoxychloroquine + azithromycin. Proving that IVM + DOXY works better than HCQ + AZT is important, if both therapies are being used in a locale and you want to know if one should be favored over the other. Having the HCQ + AZT arm as the "control group" doesn't establish the efficicay of IVM + DOXY, though. The FDA would never authorized ivermectin for treatment of covid-19 based on the Bangladesh trials because they don't have a proper control arm.
Someone told me that a funded $50 million dollar study of HCQ + AZT + zinc floundered and will never be completed, because publicity over HCQ convinced too many people that it works, and the study could not get enough subjects to agree to accept the risk of being in the control arm and not get the HCQ. True? I don't know. Twitter.
Ivermectin doesn't have that much visibility in the US, yet, so presumably Borody's trial will be able to get subjects willing to maybe get placebo instead of the triple therapy. Maybe that's what the $3500/patient is for.
[-] fyodor32768 | 2 points
They also gave everyone atorvastatin , which is another drug being evaluated clinically for COVID treatment (statin use has been associated with significantly better outcomes). So even if this group did really well, it could have been the atorvastatin
[-] TrumpLyftAlles | 1 points
Good observation, thanks!
Searching pubmed for "covid-19 atorvastatin" turns up 6 articles. I'm out of energy so I'll just leave this one here:
[-] fyodor32768 | 2 points
Yeah, there's some speculation that COVID uses (or makes?) lipids in the lungs that are inhibited by statins. It may just be that prior statin use is a proxy for general healthfulness and self care. No one really knows absent good trials.
[-] fyodor32768 | 1 points
Can anyone access the detailed results? Edit: Sorry-link is here.
[-] TrumpLyftAlles | 1 points
Why no date in the title? The "July 2020" in the article is wrong; it's brand-new. I would have put (Mexico 2020-08-24)
[-] Murky-Lengthiness | 1 points
Remember that in Mexico the reported mortality (do not believe any number the government gives, they are much higher) is 11% of those tested overall and at the seguro social (state hospital) it’s 40%.
[-] strongerthrulife | 0 points
This is massive!
[-] Murky-Lengthiness | 4 points | Aug 25 2020 12:09:39
In this investigation, the following is concluded, based on the classification of groups and type of treatment: 1 Ivermectin given in the early stages of the disease was shown to be highly effective. 2 Ivermectin as an adjuvant in the treatment of COVID- 19 patients is more effective (92%) outpatient patients. 3 In critical hospitalized and severe hospitalized patients, ivermectin had a significant impact on both improving patients' health and decreasing lethality.
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[-] luisvel | 1 points | Aug 25 2020 13:55:03
Ivermectin as an adjuvant in the treatment of COVID- 19 patients proved to be more effective in patients with outpatient treatment, 24 patients recovered 22, corresponding to 92% efficacy in this group of patients. The results are in addition to what was found by Patel (2020); Tavarez (2020) and Aguirre (2020). For the critically ill patient group, out of a total of 42 patients treated, 50% of patients (21) were recovered, and for the severe hospitalized group, 41 patients were treated and 44% (23) of the sick were recovered. In both groups of patients, apart from the increased viral load and severity of the disease, they have a longer period of elimination of the virus, ivermectin had a significant impact on both improving patients' health and lethality.
This doesn’t look as good as the title suggests.
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[-] [deleted] | 1 points | Aug 25 2020 14:22:38
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